The medial collateral ligament (MCL) is a ligament that runs down the inside of the knee. The ligament is a strong band of connective tissue that runs from the femur and the tibia. There are two collateral ligaments, the medial ligament runs through the inside of the knee and stops the knee from buckling inwards, whilst the lateral ligament runs down the outside of the knee and stops the knee from buckling outwards. Both the MCL and LCL are important in maintaining the stability of the knee.
How does it occur?
The main role of the MCL is in assisting stability by preventing excessive twisting and side to side movements particularly where the knee is forced inwards. Therefore, when these movements are excessive, the ligament is pushed past the threshold where it can maintain its structure. This results in a sprain (partial rupture) or a complete rupture.
Signs and Symptoms
Athletes may hear an audible snap or notice a tearing sensation at the time of injury. When a minor sprain occurs, you may be able to continue playing sport only to experience limited movement, stiffness and swelling in the hours following. However in severe tears, there is significant pain you will not be able to continue play. There may be gradual or immediate swelling, and you will likely experience feelings of instability. You will feel like you can't trust your knee not to buckle on turning or cutting movements.
Do you need scans?
Generally, no. Clinical testing has been shown to be very accurate in determining whether the MCL is the structure that is at fault. If it seems likely there are other structures involved following an acute injury, then a scan may be warranted. Ultrasound will show if there is any damage to the MCL, however it will not show if any structures within the joint are injured. An MRI will give full a full detailed picture an MRI will.
What should you do about it?
First step is to remove any aggravating activity and seek medical attention. Your local knee physiotherapist will be able to assess and diagnose an MCL injury. Depending on the severity of the sprain, you may be advised to go into a hinged knee brace that restricts movement. This allows scarring of the MCL to occur in the most optimal position. Conservative management will likely include manual therapy, exercise and return to sport progression depending on your goals.
Should you have surgery?
Surgery is not usually recommended as a treatment option, even for completely ruptured MCLs. Even if you were an elite athlete, surgery it is not an option that would be advised. In the absence of any other knee injury, best management is via conservative management through sports physiotherapy.
To make a booking to see your local knee physiotherapist for treatment of your MCL strain or tear, please call your local clinic or book online.